<form id="auto-data-form" action="index/feedbackSave" class="form-horizontal" method="post" role="form">
	<div style="display: none;">
		<input id="model.state" name="model.state" value="01"  type="hidden" />
	</div>
	
	<div class="form-group">
		<label for="model.type" class="col-sm-2 control-label">反馈类型</label>
		<div class="col-sm-10">
			#@dict_select("model.type",model.type,"FEEDBACK_TYPE",false,"反馈类型","")
		</div>
	</div>
	
	<div class="form-group">
		<label for="model.userName" class="col-sm-2 control-label">您的姓名</label>
		<div class="col-sm-10">
			<input id="model.userName" name="model.userName" value="#(model.userName)" placeholder="反馈人名称" class="form-control input-md" required maxlength="64"/>
		</div>
	</div>
		
	<div class="form-group">
		<label for="model.title" class="col-sm-2 control-label">反馈主题</label>
		<div class="col-sm-10">
			<input id="model.title" name="model.title" value="#(model.title)" placeholder="标题" class="form-control input-md" required maxlength="256"/>
		</div>
	</div>

	<div class="form-group">
		<label for="model.content" class="col-sm-2 control-label">反馈内容</label>
		<div class="col-sm-10">
			<textarea id="model.content" name="model.content" placeholder="反馈内容" class="form-control input-md" maxlength="65535">#(model.content)</textarea>
		</div>
	</div>
</form>
<script type="text/javascript">
	$(document).ready(function() {
	});
</script>